It’s important to understand that alcohol and drugs are toxins: They are poisons that the human body recognizes and responds to as toxic substances. Drug or alcohol detoxification is the process of eliminating these toxins from the body—hence the term, “detox.”
When an individual who has abused drugs or alcohol for a long time goes through detox, they typically experience physical and/or psychological withdrawal symptoms. These symptoms are a physiological response to the sudden decrease or elimination of the substance that the body has become dependent upon.
The detox process can be challenging. So, it’s generally safer, more comfortable, and more effective with the support of medical and mental health professionals. A team of skilled doctors and counselors can help manage the most severe withdrawal symptoms and ensure the detox and addiction recovery are completed.
The official psychiatric term for drug addiction is “substance use disorder.” And the manual that mental health professionals consult to make their diagnoses is the Diagnostic and Statistical Manual of Mental Disorders. This manual has undergone several revisions; and is currently on its fifth edition—which is why its current abbreviation is DSM-5.
A substance abuse disorder is also diagnosed according to its severity: mild, moderate, or severe.
If an individual is officially diagnosed with a substance use disorder, then undergoing a detox—as the first step in recovery from the addiction—is an excellent idea.
What withdrawal are symptoms commonly experienced during a drug or alcohol detox?
Withdrawal symptoms can range from mild to severe. And they differ from one person to the next. The specific symptoms that a person experiences, and their level of severity, will depend upon the following:
Physical detox withdrawal symptoms may include:
The most severe and dangerous alcohol or drug addiction withdrawal symptoms—known as delirium tremens (DTs)—may include:
Like the specific withdrawal symptoms that someone experiences, the length of the detox process depends on the person’s unique situation: their physical and psychological condition; the type and amount of substance they were using, etc.
Typically, drugs that are smoked or injected will leave the body faster than those that are snorted. Drugs that are swallowed will stay in the body the longest.
And different substances require different amounts of time to be fully metabolized and eliminated from the body.
Different substances stay in the body for differing periods affecting the detox time for each. Typically, a person can detox from substances within a week—though cravings and other post-acute withdrawal symptoms may persist for months or even years afterward.
This information can serve as an estimate of how long they are active in a person’s body.
1 to 3 days
(heroin and prescription painkillers like oxycodone)
1 to 3 days
2 to 4 days
1 to 7 days
(sedatives, tranquilizers, and hypnotics)
2 to 3 days
Methamphetamine and amphetamines
2 to 7 days
1 to 3 weeks
1 to 3 weeks
Detox withdrawal symptoms vary widely from one person to the next and from one substance to another. However, there are some patterns and effects that are experienced in withdrawal from a wide range of substances. For instance:
Symptoms such as irregular heartbeat, irregular breathing, and changes in blood pressure are common during withdrawal from various substances.
During withdrawal from a substance, tolerance for that substance decreases rapidly. This can be particularly dangerous if the person relapses—since they could easily overdose due to the reduced tolerance.
Symptoms that the drug was designed to reduce or control “rebound”—i.e., appear in full force—when the person stops taking the drug. During withdrawal from benzodiazepine, for instance, a person may experience intense anxiety. Or during opioid withdrawal, they might feel significant pain. Or, during withdrawal from a stimulant, they may experience severe lethargy.
Individuals whose brains have been coerced into producing too much dopamine (a feel-good chemical) may experience an extreme lack of motivation or inability to experience pleasure, during the withdrawal phase of detox.
The specific answer to this question depends upon the particular substance that is being detoxed, the physical and psychological condition of the person going through the detox, and a host of other individual factors.
With this caveat in mind, here’s a look at some average withdrawal symptom timelines for different drugs—which can help an individual and their loved ones know what to expect.
Alcohol withdrawal symptoms may include:
Opioid withdrawal symptoms can begin within 6-12 hours after the last use and peak sometime within the first week. The most severe symptoms will taper off by the end of the second week. But individuals who have used large quantities of opioids or have been addicted for an extended time may continue to experience withdrawal symptoms for months.
In medically assisted detox programs, opioid detox may be supported with drugs such as methadone and buprenorphine.
Short-acting opioid withdrawal symptoms generally begin 8-24 hours after the last use. The symptoms continue for an average of 4-10 days—though some heroin and opioid users remain on maintenance medication for months or years.
When detoxing from methadone and other longer-acting opioids, it may take 2-4 days before withdrawal symptoms begin to emerge. The symptoms typically fade within ten days.
Opioid withdrawal may include symptoms such as:
The initial barbiturate withdrawal symptoms—such as anxiety, insomnia, shaking, or circulation problems—can be expected to begin within the first two days after the last use. The symptoms will tend to peak during days 3-5. Specific withdrawal symptoms, such as insomnia, may get better and then “rebound” again, even more intensely, after a week—which would require treatment from a medical professional.
Barbiturate withdrawal symptoms may include:
Withdrawals related to benzodiazepines such as Valium and Xanax typically begin within 24 hours of the last use, and peak in about three days. By around two weeks, the most severe symptoms have generally tapered off. However, protracted withdrawal symptoms can continue to appear for months or even years—particularly for those addicted to long-acting benzos like Valium.
Symptoms of benzo withdrawal may include:
Stimulant users can expect a wave of depression within the first 72 hours of detox, followed by a “crash” that will leave them feeling depleted of all energy.
For the first week of detox, cravings for the drug will tend to subside—but often “rebound” later in the first month. Both mood swings and severe physical and emotional discomfort are expected during the first month of withdrawal.
Cocaine withdrawal symptoms generally begin within the first day of the last use, and these withdrawal symptoms may continue for weeks.
Symptoms of withdrawal from cocaine may include:
Acute meth withdrawal symptoms can include:
Post-acute withdrawal symptoms from meth can include:
Withdrawal symptoms from hallucinogens such as LSD, mescaline, psilocybin, PCP, ecstasy, ketamine, or salvia appear within 1-2 days after the last use. The initial symptoms may include headaches, drug cravings, and sweating.
Such withdrawal symptoms will tend to peak and taper off within the first week of the detox process. Also, the brain’s dopamine reward system changes may alter mood until natural levels return to normal.
Detoxing from marijuana is often easier than detoxing from other drugs or alcohol.
Withdrawal symptoms during marijuana detox typically begin within 1-3 days after discontinuation of use. The symptoms peak within ten days; a steady decline in severity starts over 10-20 days.
Marijuana withdrawal symptoms may include:
Detoxing from nicotine (via cigarettes, pipes, or chewing tobacco) creates an intense craving within four hours of the last intake. Additional withdrawal symptoms will tend to appear within the first 24 hours. After about three days, most of the nicotine withdrawal symptoms will be at their peak. And after a week, most of the symptoms will have disappeared—though some may continue for up to a month.
Common nicotine withdrawal symptoms include:
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